Into the Insulin Resistance Nightmare

:My Journey of Pregnancy & Type 1 Diabetes:

 27 Weeks 4 Days

I can't believe it's been about 10 weeks since I have had a post update.  Man, time has flown.  (Well...for the most part.)  Life has surely changed since my last post.  The pregnancy in general is still going great though :)  I've had many more doctor appointments in the last few months, but with 10 doc. appts. in the first month alone, they have actually slowed down during the second trimester. (Thank goodness!) 

Our last ultrasound was around week 25.  Baby Belle (middle name...but we might have her first name narrowed down now too)  was measuring in the 40% at 1 lb 10 oz.  She still looks great, they say, and we agree ;)  Still head down with her legs hanging out by her lil face. She is on the right side of my belly with the placenta on the left.  It's so funny because my lower, right side of my belly sticks out farther than anywhere else.  I guess, I just always thought pregnant bellies were perfectly round, haha, not so much!!  We are supposed to be getting monthly ultrasounds since week 20.  But we will have to wait about 6.5 weeks to check on her again since we will be at home during that time.  I will be close to 32 weeks by the time we get back.  I can't wait to see how big she will be by then :) (Well, I hope not too big...#diabetes.)

Now onto the not so awesome part!  I knew it was coming, but it sure hasn't made it easy.  The dreaded insulin resistance started kicking in big time around week 23.  I mean, I have been changing my basals and carb ratios ever since even before I knew I was pregnant, so it has always been hard work.....but nothing like this frustration!  I have had to change my numbers so many times during this pregnancy already that I can't even tell you exactly what my basals were before I was pregnant!  This is what a can remember pre pregnancy...

Basals (This is how much insulin I get every hour. Not based on eating.)
-between .25u to .60 depending on the time of day & month

Carb Ratios (This is what is called a bolus.  It is how much insulin I need for how many carbs I eat)
-1 unit for 26 carbs for 3 weeks of the month (1:26)
-1 until for 13 carbs for 1 week each month (1:13)
(As you can see, hormones play a big roll in messing with my resistance)

-My total daily insulin was on average of 12u-18u for the 3 weeks, and about 15u-20u for the 1 week depending on the amount of carbs and exercise each day. 

In the first trimester, things started changing a lot already.  My basals actually went down from pre pregnancy.  My carb ratios got split up into three different ratios for breakfast, lunch, and dinner.  Breakfast is definitely harder to control during the pregnancy than later in the day.  This is where I have seen my most resistance!!  During good times, my numbers will stay about the same for a week or two.  It gets harder when they start changing every 3 days or so.  You think you finally have the right calculations, and then out of no where, the highs or lows (mostly highs these days) start showing up.  Then you have to decide if it's just the food you ate, miscalculating how many carbs you ate, the timing, or if it's time to start adjusting your numbers again. 

Here are my carb ratios as of today...

Breakfast- 1:6
Lunch- 1:9
Dinner- 1:12

Huge difference from the 1:26 or 1:13 all day ratios that I had before.  My total daily insulin has already doubled!  Going from an average of 15u a day to now 30u a day.  I know it doesn't matter how much insulin I need to take to keep my baby safe, but I have always had a very low intake of insulin compared to most type 1's.  It's just hard some times to give yourself that much insulin when you are not used to it.  It's actually a good thing, and means the pregnancy is going normal.....a normal pregnant body would do this automatically.  I just need to remember that in the upcoming months when things continue to get worse.  My numbers have been pretty steady for about a week and a half, but now I'm seeing more high numbers.  It may be time to adjust.....again!  My endo says she would not be surprised if my breakfast ratios are at a 1:1 by the end of my pregnancy.  I can't even wrap my head around that.  Going from taking 1 unit for 26 carbs to having to take 26 units for that same 26 carbs just makes me shutter!!!  Ugh, I guess we will deal with that if/when it comes.  For now, I'm still dealing with these constant, yet unpredictable changes. 

My basals are starting to climb back up as well. These are more of a slow climb and not as dramatic!

-between .35u to .5u an hour depending on time of day

I have 2 more doctor appointments before we fly home next week.  One with the OB just to check up and make sure baby is doing good, and we are safe to travel.  And one with my endo.  (I go every 2 weeks right now, which is nice since it was twice a week for awhile.  Entering the 3rd trimester soon though, we will start meeting weekly and at some point twice a week again to keep up with these changes.)  I have had my labs drawn every month to check my A1C, thyroid levels (I have a mild hypothyroid also), and blood counts.  My A1C's have all been between 5.4 and 5.7, which all are considered non diabetic. (Pretty awesome!)  Since my 10.1 A1C at diagnosis, I have not had an A1C above 5.7 and I hope to keep that up as long as I can!  But believe me, it comes with a lot of hard work!!  My thyroid levels started to creep up, so we increased my dosage slightly.  So far, it seems to be working.  I also found out that my platelets are always a little low.  They say it should not be a big deal, just interesting.  My last labs also showed that my white blood count and absolute were high, meaning a possible infection.  I get my labs drawn again on Friday so we will see if they are back down or still elevated, and go from there. 

Ending on a good note, 1 week from today we will be back home again in Indiana :)  We are so excited to be able to spend 3 weeks at home!  I am a little nervous about the plane rides.  I have been having a lot of sharp pains in my ribs lately (doc says from stretching, but I say it has to be a knife or something......it's painful) and I hope I'm not too uncomfortable being that I will be between 7 & 7 1/2 months pregnant on the two flights.  At least Ry always lets me have the window seat, so hopefully I can get some sleep :)